LONG-TERM MAINTENANCE THERAPY WITH CYCLOSPORINE AND POSTTREATMENT SURVEY IN SEVERE PSORIASIS - RESULTS OF A MULTICENTER STUDY

Background: Although cyclosporine has been found to be effective thera py for severe psoriasis, only limited data exist about efficacy and sa fety during long-term treatment with a low-dose regimen. Furthermore, little is known about the course of psoriasis after drug withdrawal. O bjective: Our purpose was to assess the results of long-term therapy w ith cyclosporine for severe psoriasis with particular regard to effica cy and safety, as well as the disease course after stopping treatment. Methods: A multicenter study of 217 patients treated with 1.25, 2.5, or 5.0 mg/kg per day of cyclosporine was performed. Duration of treatm ent ranged from 6 to 30 months followed by a posttreatment period of 3 months. Efficacy was assessed by the Psoriasis Area and Severity Inde x and safety was monitored by clinical and laboratory investigations. Results: Patients with severe psoriasis showing a reduction in the Pso riasis Area and Severity Index of 75% with their individual dose of cy closporine maintained clinical improvement during continuous maintenan ce therapy. Newly occurring side effects were less frequent during the maintenance phase than in the induction phase. After withdrawal of cy closporine, worsening of psoriasis requiring antipsoriatic therapy was seen in about half of the patients. Conclusion: Cyclosporine is effec tive for long-term therapy for severe psoriasis and does not lead to s evere deterioration of the disease after drug withdrawal.